SICK. SICKER. AND STILL SICK.

Well, my rotation here in Dallas has been going well except that I've been awfully sick for just about all of it. If you'll recall, Ryan had strep throat just before I left to come here. About mid week my first week, I started feeling down...just tired and generally lousy. By that Thursday, I was running fever with lymph nodes swollen and a terribly painful sore throat. I was voted off the island at work and sent to the doctor, with the assumption I probably had strep, too. Well, the test was negative, but the doc gave me antibiotics and steroids because I was in really rough shape. Over the weekend, my sore throat migrated down to about my voice box, and I developed some awesome asthma trouble and a cough that just wouldn't let up. I was going through Robitussin, NyQuil, and cough drops like water and using my nebulizer and rescue inhaler about 3 times each day. When I couldn't swallow without grimacing, I decided it was time to head back to the doc. I left with another negative strep test, a steroid shot, another week's worth of steroid pills, meds for my asthma, prescription cough medicine, and some lidocaine for my throat. That night, I actually got some sleep! Some was better than the next to no sleep I'd been getting before. I expected improvement, but about 5 days later, I still am miserable. Improvement, yes, but certainly not nearly up to par yet. So I went back to the doc this morning. I left with a clear chest xray, another negative strep test, different antibiotics (for 2 weeks! yikes!), and a different prescription cough medicine. Here's hoping this finally clears up. With only one week left here, if this clears up, it looks like it will be just in time to head back home. I'll be very glad to feel better, but I wish I could have spent more time with family and friends while I was here. I still have this one week left, so hopefully I'll feel well enough to make the best out of it.

SURPRISE!

Jason, one of our roommates, turned 30 on Feb 4. His girlfriend Heather, our other roommate, threw him an awesome surprise birthday party. She's been planning this for months, and I'm really proud of us all for keeping our mouths shut. I really don't think he had a clue. She got a bunch of his friends to come into town from Corpus Christi and from Michigan. His parents and sister were sweet enough to come all the way from Michigan to be part of the surprise, too. Heather's mom even came to town for the big event. We had everyone at the house getting ready while Ryan took Jason out golfing...which almost got nixed due to rain. Poor Ryan, he did a great job. His entire job for the day was to keep Jason occupied until we gave him the OK to come back home, and I'll tell ya, that wasn't an easy task! So while they were out, Heather and I were running errands and getting the house ready with lots of help from some of Jason's and Heather's family and friends. When the boys got home, we had all the cars hidden and the guests hiding, too. Jason saw tons of decorations and me when he walked in...but that was it. He looked awfully confused! He took one more step, then everyone yelled "surprise!" and jumped out. He seemed to happy to see everyone! We had some yummy Tex-Mex for dinner, then hit downtown in a party bus...all Heather's ideas. It really all went off well, and everyone seemed to have a great time. His family stayed in town for a few days to see Galveston, NASA, and some other local stuff, but everyone else had to head back pretty quickly the next day. Thanks again to everyone who came out for making it such a success. Many thanks to Ryan for owning the most difficult job of the day, and huge props to Heather for pulling it all off! Fun times! I'll try to get some pictures posted when I get back home and can confiscate them from Heather.

UUGGGHHHHH!

Ok, that's about how I feel. My brain can barely form words right now. This week has been INSANE. On top of the usual days full of work at the hospitals, I have finished my 13-page paper over bone tumors and cysts, finished my rotation and got all the end-of-rotation business taken care of, finished a ridiculous amount of the world's most boring task-patient logging, healed a hubby with strep throat and I haven't caught it (yet), found a puppy then found her a home, dealt with a sick cat...and still have Roomie's 30th birthday on Saturday that I'd like to be awake for, then I have to pack/move/clean house on Sunday for a 4-week rotation 5 hours away. Yes, by the way, my and Ryan's 8-year anniversary is tomorrow. Sleep? I think not.

CARDIOLOGY. DONE.

I'll admit that I was super anxious headed into this rotation. Probably more anxious than any rotation except ER, that one was kinda scary too. But I can barely believe that it's actually my last week here! And I must say that I have quite enjoyed it. They have given me some great independence, which I enjoy, but this has also tested my knowledge and skills. I've had the joy of meeting lots of wonderful practitioners from various fields, and learning from them as well as my preceptors. My preceptors have all been fantastic to work with. They are kind, patient, and always available when I have a question or concern. The patients have been dynamic and each one presents to me a different set of circumstances to consider. I may not have learned as much about cardiology in particular as I might have if I had stayed in clinic all the time, but this rotation has taught me more about medicine in general, cardiology included, addressing a variety of disease processes, and has tested me as an independent provider. It has really been a great rotation and one that I am thankful I got placed on.

DUCKS!!!

Anyone that knows me well, knows that I just love ducks. They're so cute! When Ryan and I were first dating, he actually bought me 2 ducklings which we raised in my parents' back yard...probably not the best decision either of us have ever made, but we just loved them nonetheless. We have a siberian husky dog named Goose, so we actually had Duck, Duck, Goose :) Yup, I'm a total nerd and found that amusing for the entire time we had the ducks. Anyways, in our neighborhood now, there are a few ponds with lots of ducks! It's one of my favorite sites when I go jogging. I don't know, they just make me smile. I am bias towards two of them. They are always together, and they are about the most unique ducks I've ever seen. I call them Puff Duck and Dalmatian Duck. The white one has a little afro! Come on, tell me that doesn't make you smile!

With spring coming, there are also baby ducks at the pond! Oh, they're just adorable with their little yellow fuzz. One momma duck has about 7 babies with her right now.

Ok, that meets my cute duck quota for a little while...back to school stuff...

HAPPY BIRTHDAY!

Happy birthday, Ryan! Ryan turned 29 on January 19. We celebrated on his birthday with dinner at Saltgrass, then the next night we went out with friends for Hibachi and drinks. We even had our first Sake bombs! We had a fantastic time, and thanks to Heather, Jason, Lindsay, and Lonnie for coming out with us. I wanted to get a picture of all of us out, partially to prove that yes, we PA students DO manage to get out every now and again to go have fun. But, we got distracted and never got a pic. :( I managed to get a picture of the food though! lol

This was Ryan's present from me. I felt like being mischievous, so I wrapped it in consecutive boxes with different kinds of wrapping paper. On the last layer, you can see princess, dancing birthday monkeys, and Christmas paper :). It was a very small box, about 2 X 4 X 4 inches, and the largest box here was for a rolling garage toolbox...many boxes in between! Oh, it was fun.

MATTERS OF THE HEART

Well, it's back to the grind now. No more vacay :( But that's okay, I had a fantastic month off and am very grateful to be rested and ready to go. First up for this year is cardiology. I was stressing about this rotation for a few reasons. First, the heart is one of my weaker subjects. There is so much to remember, and it all gets inter-twined. I'm hard of hearing, so hearing murmurs can be very difficult. Second, there are so many contributing factors that make this less of a action/reaction, direct effect, instant gratification specialty. I like to see a problem and fix it, which is harder in cardiology than it is in other specialties. Third, my next rotation will be vascular in nature, so this whole heart thing is going to be a big deal then, too, so I'd better be paying attention! And lastly, I've been on vacation for a month. Going from doing whatever I dang well please all day every day straight to keeping someone else's schedule and explaining my every move is not an easy transition.

With all that said, I have honestly really enjoyed my rotation so far. I wanted independence, and I got a big dose of it! I'm rounding on my own at the hospitals, so I see lots of patients with a variety of ailments. The best part is that while I'm mainly concerned about cardiology-related issues, I'm treating a whole patient and have to consider the whole picture, so it really keeps me interested. I can look up stuff I have questions on, and I can always call my preceptor with more questions or concerns.

This has been a whole new experience in another aspect-most of my patients are in ICU or long term care facilities. That means that their situations are very fragile and can literally change by the day. This is the first time I've ever had to convey that to a family. I don't think I've ever chosen my words so carefully. I also have to watch for the subtlest signs or changes in lab values each day. It has made me realize, again, how important it is for EVERY person to discuss with their loved ones what their wishes are if they become incapacitated. Please keep in mind that from my view, incapacitated doesn't always mean dying...it has a variety of implications, including severe dementia, dehabilitating infection, changes in psyche, and otherwise. And it's not always a permanent situation. It's important to discuss resuscitation, intubation, "life support," restraints, medications, etc...don't leave some subjects unbreached because it makes for an uncomfortable discussion. It breaks my heart to see families in distress over what their loved one would want in a time that already brings about such emotion. It breaks my heart even more to see families go into denial regarding very real situations, and watch them simply leave family members behind at the hospital. Would you want your family to leave you in a hospital bed for an undetermined amount of time and come visit once a month for 15 minutes because it makes THEM uncomfortable to think about it? It's never an easy conversation, but being in the heat of the moment won't make the decisions any easier or any more clear. I'm sorry to bum yall out on a beautiful Sunday morning, but this really weighs heavily on my heart today, and I saw it way too often in just one week. On a happier note, I also saw true love this week. I saw spouses come sit bedside all day, every day. They knew what their loved one wanted, and did everything possible to uphold that. They would read, make sure favorite TV shows were playing, talk, and even hold hands. And sometimes, I saw the patient respond to such love with a squeeze of the hand, a head nod, or even as subtle as blinking-once for no, twice for yes.

Realizing how fragile life as you know it can be, I think I learned from my patients that it's probably better if we all take it just one day at time, and never pass up an opportunity to show love or have meaningful conversation with our loved ones. Thank you, week one of an intimidating rotation, for teaching me such a valuable lesson.